The Companies Act (1 of 1956)

Schedule V - Part II
(See Section 159)
Annual Return
Of
Form of Annual Return of A Company Having a Share Capital
The Companies Act (1 of 1956)
Annual Return
Schedule V - Part II
(See Section 159)
Registration Details
State Code

(Refer Code List 1)

Registration No.
Registration

Whether shares listed on

Date

recognised Stock Exchange(s)

Date

Month

Year
Y Yes, N- No

If yes, Stock exchange code (Totals) (Refer

Code List 2)
AGM Held

Y - Yes

Date of AGM/

N - No

Due Date
Date

Name and Registered Office Address of Company

Company
Name

Address

Town/City
State
Telephone
With STD
Fax Number

Pin Code

Month

Year

Email
Address

Capital Structure of the Company (Amount in Rs. Thousand)

- Authorised Share Capital Breakup
Type of shares
(i)

Equity

(ii)

Preference

No. of shares

Nominal value (in Rs.)

No. of shares

Nominal value (in Rs.)

Total Authorised Capital

- Issued Share Capital Breakup

Type of shares
(i)

Equity

(ii)

Preference

Total Issued Capital

- Subscribed Share Capital Breakup

Type of shares

No. of shares

Nominal value (in

Rs.)

(i) Equity
(ii)

Preference

Total Subscribed Capital

- Paid-Up Share Capital Breakup

Type of shares

No. of shares

Nominal value (in

Rs.)

(i) Equity
(ii)

Preference

Total Paid-Up Capital

- Debentures Breakup
Type of shares
(i)

Non Convertible

(ii)

Partly Convertible

(iii)

Fully Convertible

Total Amount

No. of shares

Nominal value (in Rs.)

Directors/ Manager/ Secretary Information (Past and Present)

[Refer clause 6 of Part I of Schedule V]
Name
Middle Name

First Name

Surname
I Indian

Nationality

Date of Birth

F Foreign
Date

Month

Year

C Chairman cum Managing Director

W- Whole Time Director, S Secretary, R Manager

Designation

D Director, M Managing Director

Date of

Date of

Appointment

ceasing
Date

Month

Year

Date

Month

Year

Election Commission
Identity Card No.
Name
Surname

Middle Name

I Indian

Nationality

First Name

Date of Birth

F Foreign
Date

Month

Year

C Chairman cum Managing Director

W- Whole Time Director, S Secretary, R Manager

Designation

D Director, M Managing Director

Date of

Date of

Appointment

ceasing
Date

Month

Year

Date

Month

Year

Election
Commission
Identity Card No.
Name

Surname
Nationality

I Indian
F
Foreign

Middle Name
Date of Birth

First Name

Date

Month

Year

C Chairman cum Managing Director

W- Whole Time Director, S Secretary, R Manager

Designation

D Director, M Managing Director

Date of

Date of

Appointment

ceasing
Year
Date

Month

Year

Election Commission
Identity Card No.

Directors/ Manager/ Secretary Information (Contd.)

Residential
Address

Town/City
District
State
Pin Code
Residential
Address

Town/City
District
State
Pin Code
Residential
Address

Town/City
District
State
Pin Code

Note: Additional Sheets may be attached if needed.

Date

Month

Details of shares/ Debentures Held at Date of AGM *

Ledger Folio of share/ Debenture Holder
Share/
Debenture
Holders
Name

Surname

Middle Name

First Name

Fathers/
Husbands
Name
Type of Share/

1 Equity, 2- Preference Shares,

Debenture

3 Debentures, 4 - Stock

Number of Shares/
Debentures

Amount per Share

(in Rs.)

Held/ Stock, if any

Ledger Folio of share/ Debenture Holder

Share/
Debenture
Holders
Name
Surname

Middle Name

First Name

Fathers/
Husbands
Name
Type of Share/

1 Equity, 2- Preference Shares, 3 Debentures, 4 - Stock

Debenture
Number of Shares/
Debentures

Amount per
Share

Held/ Stock, if any

(in Rs.)

Ledger Folio of share/ Debenture Holder

Share/
Debenture
Holders
Name
Surname

Middle Name

Fathers/
Husbands
Name
Type of Share/
Debenture

1 Equity, 2- Preference Shares,3 Debentures, 4 - Stock

First Name

Number of Shares/
Debentures

Amount per Share

(in Rs.)

Held/ Stock, if any

Note: Separate sheet may be attached if needed. If number of such share holders exceed 10, if so desired a
text file may be submitted on a floppy or a cartridge tape in the format given in Annexure III.

Details of shares/ Debentures Held at Date of AGM (Contd.)

Address

Town/City
District
State
Pin Code

Address

Town/City
District
State
Pin Code

Address

Town/City
District
State
Pin Code

Details of Shares/ Debentures Transfers since Date of last AGM (or in the case of the first return
at any time since the incorporation of the company) *
Date of Previous AGM
Date

Month

Year

Date of Registration of Transfer of

Shares
Date
Type of

Month

Year

1 Equity, 2- Preference Shares,3 Debentures, 4 - Stock

Transfer
Number of Shares/

Amount per Share

Debentures Transferred

(in Rs.)

Ledger Folio of
Transferror
Transferrors
Name
Surname

Middle Name

First Name

Surname

Middle Name

First Name

Ledger Folio of Transferree

Transferrees
Name

Date of Registration of Transfer of Shares

Date
Type of
Transfer

Month

Year

1 Equity, 2- Preference Shares,3 Debentures, 4 - Stock

Number of Shares/
Debentures Transferred

Amount per Share

(in Rs.)

Ledger Folio of Transferror

Transferrors
Name
Surname

Middle Name

First Name

Ledger Folio of
Transferree
Transferrees
Name

Surname

Middle Name

First Name

Note: Separate sheet may be attached if needed. If number of such share holders exceed 10, if so desired a
text file may be submitted on a floppy or a cartridge tape in the format given in Annexure IV.

Indebtedness of the Company (Amount in Rs. Thousand) [Secured Loans including

interest outstanding / accrued but not due for payment
Amount

Equity Share Capital Breakup [Percentage of Total Equity]

(i) Govt. [Central & State(s)]

(ii) Govt. Companies

(iii) Public Financial

(iv) Nationalised/ Other Institutions Banks

(v) Mutual Funds

(vi) Venture Capital

(vii) Foreign Holdings (FIIs/FCs/FFIs/NRIs / OCBs

(viii) Bodies Corporate (Not Mentioned Above)

(ix) Directors / Relatives

(x) Other top 50 Share Holders of Directors [Other than those

listed above]

We certify that :

the return states the facts as they stood on the date of the annual general meeting
aforesaid, correctly and completely;

since the date of the last annual return the transfer of all shares, debentures, the issue of
all further certificates of shares and debentures have been appropriately recorded in the
books maintained for the purpose;

the whole of the amount of dividend remaining unpaid or unclaimed for a period of three
years from the date of transfer to the special account has been transferred to the General
Revenue Account of the Central Government as required under sub-section (5) of
Section 205 A:

the company has not, since the date of the annual general meeting with reference to
which the last return was submitted, or in the case of a first return, since the date of the
incorporation of the company, issued any invitation to the public to subscribe for any
shares or debentures of the company;

where the annual return discloses the fact that the number of members of the company
exceed fifty, the excess consists wholly of persons who under sub-clause (1) section 3
are not to be included in the reckoning the number of fifty.

since the date of annual general meeting with reference to which the last return was
submitted or in the case of a first return since the date of the incorporation of the private
company, no public company or deemed public company has or have held twenty five
percent, or more of its paid up share capital;

the company did not have an average turnover of Rs. Ten Crores or more during the
relevant period;

since the date of annual general meeting with reference to which the last annual return
was submitted or since the date of incorporation of the company, if it is first return, the
company did not hold twenty five percent or more of the paid up share capital of one or
more public companies;
and

the private company did not accept or renew or invite deposits from the public
Signed

Director : __________________________________

Director / Managing Director/

Manager / Secretary : __________________________________
Secretay in whole time practice : ___________________________________
CP No. : __________________________________
_____________________________________________________________________________
__________________________

Note : Certificates to be given by a Director and Manager/ Secretary or by two Directors where
there is no manager or secretary. In the case of a company whose shares are listed on a
recognised stock exchange, the certificates shall also be signed by a secretary in whole time
practice.
Annexure I
Code List 1 : State Codes
State
Code

State Name

State
Code

State Name

01 Andhra Pradesh

02 Assam

03 Bihar

04 Gujarat

05 Haryana

06 Himachal Pradesh

07 Jammu & Kashmir

08 Karnataka

09 Kerala

10 Madhya Pradesh

11 Maharashtra

12 Manipur

13 Meghalaya

14 Nagaland

15 Orissa

16 Punjab

17 Rajasthan

18 Tamil Nadu

20 Uttar Pradesh

21 West Bengal

22 Sikkim

23 Arunachal Pradesh

24 Goa

52 Andaman Islands

53 Chandigarh

54 Dadra Islands

55 Delhi

56 Daman & Diu

57 Lakshwadeep

58 Mizoram

59 Pondicherry

Annexure II
Code List 2 : Stock Exchange Codes
Exchange

Stock Exchange

Code

Exchange

Stock Exchange

Code
Bombay
A1

OTCEI
B1

Delhi
A2

Nagpur
B2

Calcutta
A4

Coimbatore
B4

Madras
A8

Cochin
B8

Bangalore

MP

A16

B16
Hyderabad

Jaipur

A32

B32
Ahmedabad

Rajkot

A64

B64
Pune

Gauhati

A128

B128
Kanpur

Bhubaneshwar

A256

B256
Ludhiana

Magadh

A512

B512
National Stock

Vadodra

A1024

B1024
Exchange

Rajkot
B2048

Note: If listed in more then one exchange, add the respective codes to arrive at the Totals under the same
category. For example a company listed in Bombay, Pune, Nagpur and Cochin will fill in the exchange codes
as follows:

Annexure III
Shares / Debentures held : (format for floppies)
Registration Details
Field

Length

Type

Format/

Value
State Code

Number
2

Registration No.

Number
6

Date of AGM

Date

(DD/MM/YY)
8

Date of last AGM

Date

(DD/MM/YY)
8

Note: The first text file cid.txt will contain the data for above field for Company identification.

Shares held by Share Holders

Field

Type

Length

Format/

Value
Ledger folio of Share-holder

Character
8

Name of shareholder

Surname
Middlename

Character
20

Fathers/ Husbands Name

Surname
Middlename

Character
20

Residential Address

Firstname

Firstname

Character
40

Town/ City

Character
20

State

Character
20

Pin Code

Number
6

Type of Shares/

Number

Debentures

1 Equity
2 Preference
3 Debentures
4 Stock

No. of Shares/ Debentures

Number
6

Amount per Share/ Debentures

Number
6

Note: The second text file shh.txt will contain the data for above fields for the share holders/ debenture
holders.

The file may be submitted in 5.25" or 3.5" floppies (preferably 3.5") or 60/150 MB Normal
Cartridge Tapes (mini Cartridges not acceptable) The Floppies/ Cartridges may be formatted in
DOS/ Unix.

Annexure IV
Shares Transferred : (Format for floppies)
Registration Details
Field

Type

Length

Format/

Value
State Code

Number
2

Registration No.

Number
6

Date of AGM

Date

(DD/MM/YY)
8

Date of last AGM

Date

(DD/MM/YY)
8

Note: The first text file cid.txt will contain the data for above field for Company identification.

Transactions after the last AGM

Field
Date of Transfer of Share

Type

Length Value

Format/

Date

(DD/MM/YY)
8

Type of Shares/Debentures

Number
1

1 Equity
2 Preference
3 Debentures
4 Stock

No. of Shares/ Debentures

Number
6

Amount per Share/ Debentures

Number
6

Ledger folio of Transferror

Character
8

Name of Transferror

Surname
Middlename

Character
20

Firstname

Note: The second text file sht.txt will contain the data for above fields for each such share transfer.

The file may be submitted in 5.25" or 3.5" floppies (preferably 3.5") or 60/150 MB Normal
Cartridge Tapes
(mini Cartridges not acceptable) The Floppies/ Cartridges may be formatted in DOS/ Unix